Fear of the Military vs Fear of Loans

[PistolPete3]

Hello all,

Thank you in advance for the help. I am an aerospace engineer planning on attending medical school in the fall. I have been lucky enough to get accepted to my top choice schools, but none of the low cost schools to which I applied. I also have thought long and hard about HPSP and got my paperwork together, but never completed the submission.

As I start to really do a financial analysis on the loans (probably 250-275k), I am starting to wonder if HPSP might be the right decision. My recruiter contacted me and said it is not too late to submit, but I am not a fan of making this decision out of fear.

I see both the debt and the military as substantial commitments that may have a significant impact on my quality of life. The military does offer some unique opportunities (especially for an aerospace guy that loves flight), but there is a significant cost to any commitment extending out so many years.

I will allow that without the financial consideration I would not be considering the scholarship. I know many say to rule out the financial carrot, but would anyone choose HPSP without it? The way I see it taking out 270k ballooning to ~330k after school and ~450k after residency (vague estimates) represents a pretty tremendous commitment and a significant potential downside to medicine.

Honestly if I were only signing up for a four year military commitment I would take the scholarship without question. Given the reality of the military match and residency, the decision is a bit more difficult.

I know I am far from alone, but does anyone have strong opinions or guidance? Thanks also to everyone in the military med forums who responded to my last post.

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[NickNaylor]

Almost anyone that has done the HPSP will tell you that you should do it only if you want to be in the military independent of the loan repayment. I'm not involved myself, but this is what I've heard from several people. A guy in my class who is doing the HPSP through the Army definitely seems like he's in that camp. You mention the concerns about training which are also worth considering, though I admit that I'm not too familiar with those things.

Don't do it just for the money. You'll likely regret it.

 

[Mt Kilimanjaro]

If you have time to read a book about decision making that might help you think it through, read the last half of this one: http://www.amazon.com/Thinking-Fast-Slow-Daniel-Kahneman/dp/0374533555

General advice is to make decisions like this based on your gut and the information you have now. You can't predict who you will marry or what specialty you'll end up going into or other things that will alter your future course. The clearer and more rigid your future goals are, the less you should probably consider the military.

I'd ask these questions too:
What specialties are you most interested in? Professional spouse? Kids? Only happy in big cities?

Ask the recruiter to set you up with a site visit to a military facility outside of the DC area (even though it says you're there). Ask yourself if you could be happy in that place.

 

[Burla]

I'd take the predictability of loans over the unpredictability of the military any day

 

[Mr Roboto]

If you want to be in the armed services, do HPSP.

If you're not sure about the armed services, don't do HPSP.

The money shouldn't be a factor in your decision because you come out financially ahead by using loans in almost every situation. And with the army you run the risk of being assigned as a general medical officer instead of having a real residency, which really effs up your career.

 

[BenzylAcetate]

I had the same questions after I was accepted to one of the most expensive DO schools. I ran the numbers a few different ways, but I found the tipping point was usually between 70-75k cost of attendance per year being the point at which HPSP was significantly favorable. For reference,

http://forums.studentdoctor.net/threads/hpsp-financial-analysis.1033627/

Think about what you want out of life over the next few years as well as your career long term. If you would be comfortable living frugally for a few years post residency and really working to repay your loans, then HPSP is definitely not worth it unless you have a burning desire to join the military.

Do a very thorough financial analysis for yourself to get an idea of the real dollar benefit of HPSP, I think you will find it is significantly less than anticipated given some of the initial numbers.

 

[Espadaleader]

Think about joining the uniformed Public Health Service through the COSTEP program.

 

[ærospallo]

...[Y]ou should do it only if you want to be in the military independent of the loan repayment.

This.

 

[alpinism]

Don't do it just for the money. You'll likely regret it.

If you want to be in the armed services, do HPSP.

If you're not sure about the armed services, don't do HPSP.

This.

I'll say it again just for emphasis.

Don't do HPSP for the money. You'll likely end up being very unhappy and regret the decision.

Thousands of med students attend expensive private schools every year and nearly everyone pays off their loans without any problems.

 

[studentp0x]

OP, don't join the military for money.

 

[circulus vitios]

It's been a long time since I've run the calculations, but from what I remember you won't come out ahead with HPSP unless you go to a >$70k/yr COA school and you choose a low-paying specialty. The "four" years of service isn't really four years because you have part-time military obligations throughout medical school and residency, and you should know that the "four" years of service also increases if you do a residency that is >4 years in length e.g. just about any surgical specialty. The military match process can also keep you from matching into the specialty you want, and it's absolutely harder to do a fellowship in the military.

 

[mvenus929]

As a military dependent through most of my life, I will tell you (again) to only do HPSP if you want to join the military. It's not a bad deal if you want to do Family Medicine, but if you want to do anything outside a primary care field, it becomes very difficult to match into a military residency, and most branches/positions don't allow you to defer military service to do a civilian residency.

Keep your options open, especially if you haven't gotten financial aid packets yet. Some of the offers can be quite impressive and drastically reduce your COA. You can also join HPSP later for a shorter commitment if it turns out to be something you do want to do.

 

[1012526fs]

Or, ask the healthcare recruiter what your options are if you take out loans, do a civilian residency of choice, and THEN join the military to have them pay off your loans. At least you'd have the option of ruling out the whole military residency options issue, and you'd have several more years to consider the military lifestyle and whether it is for you or not.

 

[TooMuchResearch]

Or, ask the healthcare recruiter what your options are if you take out loans, do a civilian residency of choice, and THEN join the military to have them pay off your loans. At least you'd have the option of ruling out the whole military residency options issue, and you'd have several more years to consider the military lifestyle and whether it is for you or not.

Recruiters are not a reliable source of information for many reasons.

 

[Lil Mick]

I did ROTC in college--great experience with the military, wanted to serve however I could serve. Don't do it if you really don't want to be in the military. If you're not sure, I'd be happy to talk about it (send me a pm), and there's a forum on SDN with folks who have gone that route.

 

[Patros]

I am copy-pasting some links I posted in another thread, you might find them useful. The first two are military-related, but the others are not, so see if any of them are up your alley.

Army loan repayment: Join the army as a medical officer, and they will pay off your loans.
Health Professions Scholarship Program: Apply upon entering medical school. The army (linked), navy, or air force will pay your way through medical school (tuition coverage and living stipend). This is what you are considering now.


NIH loan repayment: If you are interested in scientific research, then the NIH will repay your loans as long as you work in a scientific capacity.
National Health Service Corps scholarship: If you are interested in primary care, this scholarship will completely reimburse your tuition and give you a stipend in return for ~4 years of primary care work in a location they designate.

Also see this database for other scholarship and loan repayment programs.

 

[medicalmnt]

I plan on joining the military or navy sometime in my life. (as a MD)
Regardless of debt.

 

[dr zaius]

Head on over to the military medicine subforum here on student doctor. Check out the sticky threads. They are a great source of information and give you an idea of what you can expect in military medicine.

 

[hubriz]

Hello all,

Thank you in advance for the help. I am an aerospace engineer planning on attending medical school in the fall. I have been lucky enough to get accepted to my top choice schools, but none of the low cost schools to which I applied. I also have thought long and hard about HPSP and got my paperwork together, but never completed the submission.

As I start to really do a financial analysis on the loans (probably 250-275k), I am starting to wonder if HPSP might be the right decision. My recruiter contacted me and said it is not too late to submit, but I am not a fan of making this decision out of fear.

I see both the debt and the military as substantial commitments that may have a significant impact on my quality of life. The military does offer some unique opportunities (especially for an aerospace guy that loves flight), but there is a significant cost to any commitment extending out so many years.

I will allow that without the financial consideration I would not be considering the scholarship. I know many say to rule out the financial carrot, but would anyone choose HPSP without it? The way I see it taking out 270k ballooning to ~330k after school and ~450k after residency (vague estimates) represents a pretty tremendous commitment and a significant potential downside to medicine.

Honestly if I were only signing up for a four year military commitment I would take the scholarship without question. Given the reality of the military match and residency, the decision is a bit more difficult.

I would recommend you not doing HPSP. You can consider FAP or entering post-residency, which will likely result in a substantial signing bonus or loan repayment option and only require a 3-4 year commitment. A big downside to HPSP and other pre-residency commissioning programs is that you a will incur additional time if you choose to do a military residency, so that 4-year commitment can and will easily turn into a 16-year commitment depending on your specialty. Moreover, you must apply to the military match, and the needs of the military come first. I'm an active duty officer and am in the process of separating. My decision to attend medical school comes at a steep cost both personally and financially, and because I intend to fully allow my medical education to inform and influence my career choice, I don't find it reasonable to limit my options before experiencing medical school and knowing what it is I want to do in medicine. I think it's crazy to do that, if first and foremost you want to be a physician. Like was previously stated, if you know you want the dual satisfaction of being a military officer and a physician, go for it. But, I caution people against making that decision prior to experiencing the military first-hand.

Also, you may be able to find outside scholarships to defray your tuition without incurring any service obligation.

 

[abn632]

I will echo what others have said: join the military only if you WANT to be in the military. Do not join just for the money. However, an alternative to consider is the Reserve/National Guard.

Read the info at this well-written article: http://whitecoatinvestor.com/army-national-guard-physicians/

Keep in mind that there are many federal student loan repayment plans. Also keep in mind that there are some good loan repayment programs for serving in underserved areas. Paying back loans suck, but you'll likely make enough in the future as a physician to afford your loan payments. You will probably not make any less than $150,000 per year (after residency) for the rest of your life. Holding everything else constant, a salary of $150,000/year grosses $12,500/month. Payments for a starting loan balance of $400,000 at 7% are $2,735/month for 25 years. Assuming 30% of your gross is lost for all taxes (federal, state, local, etc.), you net $8,750/month. After your loan payment, you have $6,015 left over, or $72,200/year, to pay for housing, utilities, insurance, food, etc. You're not exactly a baller, but you're not living off of beans and rice, either. The median income for the US is around $50,000 gross per year. Netting $72K/year is not too shabby.

These are rough calculations using a high interest rate and high loan balance and a primary care income. Adjust as necessary. These calculations also do not take into account the likelihood of your pay increasing over time (and therefore the diminishing impact of your student loans over time on your income). Participating in a repayment program (e.g. underserved area, military FAP, etc.) helps out significantly.

 

[mehc012]

I don't understand doing HPSP, EVER. It's a decision made before some of the most perspective-changing 4yrs of your life. If you decide to use the military to get out of loans, look into FAP. Less risk of tanking your specialty choices, more chances to change your mind once your perspective/life situation has changed, BEFORE taking the plunge.

 

[hubriz]

I don't understand doing HPSP, EVER. It's a decision made before some of the most perspective-changing 4yrs of your life. If you decide to use the military to get out of loans, look into FAP. Less risk of tanking your specialty choices, more chances to change your mind once your perspective/life situation has changed, BEFORE taking the plunge.

I agree 1 gazillion bazillion bamillion percent.

 

[seeinghowitgoes]

If you have time to read a book about decision making that might help you think it through, read the last half of this one: http://www.amazon.com/Thinking-Fast-Slow-Daniel-Kahneman/dp/0374533555

General advice is to make decisions like this based on your gut and the information you have now. You can't predict who you will marry or what specialty you'll end up going into or other things that will alter your future course. The clearer and more rigid your future goals are, the less you should probably consider the military.

I'd ask these questions too:
What specialties are you most interested in? Professional spouse? Kids? Only happy in big cities?

Ask the recruiter to set you up with a site visit to a military facility outside of the DC area (even though it says you're there). Ask yourself if you could be happy in that place.

Just wanted to drop by to say I literally bought this book after reading your post (and then some of its reviews). Great stuff so far!

 

[touchpause13]

Do you want to be in the military regardless of loans? If the answer is no, then under no circumstances should you go that route.

 

[The Buff OP]

@PistolPete3
I gave the military a lot of thought and my final decision was not to go into it. After I talked to some military physicians on there they seem to be pretty unhappy. I saw a guy who made a thread about how long he has left of service then other guys posted and how many days they have left and they can't wait until they get out. You won't be the first one who has to pay back loans for medical school, so don't worry about it. Do you have a specialty in mind as of right now?

Most guys who go into the HPSP don't get to start residency until they have done a GMO tour. You will bored to death and beg someone who went the FAP route to shadow them on their clinic.

If you go the FAP route they will only take a specialty that is in need for them.

 

[mehc012]

@PistolPete3

Most guys who go into the HPSP don't get to start residency until they have done a GMO tour. You will bored to death and beg someone who went the FAP route to shadow them on their clinic.

If you go the FAP route they will only take a specialty that is in need for them.

You will end up in a specialty the military needs either way (HPSP or FAP).
With FAP you at least get to choose your own specialty beforehand. If I ended up being interested in something the military didn't need, I would rather have the ability to decide between 'military-needed' specialties with the ability to do FAP and my dream job with loan debt after med school rather than before, when I have no perspective on the matter.

 

[The Buff OP]

You will end up in a specialty the military needs either way (HPSP or FAP).
With FAP you at least get to choose your own specialty beforehand. If I ended up being interested in something the military didn't need, I would rather have the ability to decide between 'military-needed' specialties with the ability to do FAP and my dream job with loan debt after med school rather than before, when I have no perspective on the matter.

Oh Hey @mehc012
Yeah, I heard the same thing for HPSP what ever is in need. I was gonna go for the FAP route. I wanted to do a civilian residency and do my dream specialty.

 

[mehc012]

Oh Hey @mehc012
Yeah, I heard the same thing for HPSP what ever is in need. I was gonna go for the FAP route. I wanted to do a civilian residency and do my dream specialty.

Agreed. Most of my current, naively-coveted specialties would likely appeal to the military folks, but I'd rather a) make sure I like them rather than banking on not maturing at all in the next 5yrs and b) make sure I can get them and get some awesome training in them even if the military changes its preferences!

 

[IlDestriero]

I lost a fortune taking HPSP, but I wanted to serve and I can't say that I really care. I was in active duty through 911 and its aftermath. Interesting times.
Life changing.
I'll take that over another $500k+ any day.
It made me a better person, a better citizen, and likely helped quite a bit in my current success.